Teledentistry program takes oral care offsite
Imagine receiving professional care for your teeth — exams, X-rays, sealants, even cleanings — and never once reclining in the dentist's chair.
That's what Cornelius-based Virginia Garcia Memorial Health Center's new teledentistry program offered to elementary students in Washington County last fall as part of a pilot project modeled after one in San Francisco, Calif.
It all started with Dr. Paul Glassman of the University of the Pacific, whose idea to bring dental care to at-risk populations instead of requiring them to visit a dentist's office has been wildly successful.
"This is the virtual dentistry concept," said Dr. Lisa Bozzetti, dental director at VGMHC, a dentist herself and a California native. "It takes the role of a dental hygienist who goes out into the community ... and gives oral health information to a dentist who's not onsite. He or she reviews those records and provides feedback in close collaboration with the hygienist."
A major goal of the local pilot program — which focused on Echo Shaw Elementary in Forest Grove and Aloha-Huber Park K-8 School in Beaverton, both high-poverty schools — was to remove barriers to oral care for people who are unlikely to visit a regular dentist's office.
"Often, these parents find it hard to get time off work or there's a lack of transportation involved," noted Bozzetti, who graduated from California's Loma Linda University in 2002 and joined VGMHC in 2007. "One of the key elements is providing dental care so folks are not necessarily having to come into the clinic — that's where you're losing a lot of people.
"We're meeting them where they are."
Over eight weeks in October and November, Virginia Garcia hygienists saw 123 students at the two schools, providing dental assessments and sealants to prevent cavities, said Kyle Allen, dental operations manager for VGMHC's School Based Health Center.
Allen, who's also a Hillsboro city councilor, emphasized the need for dental care among high-risk students. Seventy percent of students at Aloha-Huber Park are on free- and reduced-price lunches, and 90 percent of students at Echo Shaw receive federally-subsidized meals.
"We focused on first- through third-graders and sixth- and seventh-graders, because the first four permanent molars come in at the younger ages and the second set comes in at grades six and seven," noted Allen. "We provided more than 100 kids with a dental assessment, varnishes, cleanings, sealants, portable X-rays and intraoral photos, which were analyzed offsite."
It wasn't unusual for a hygienist to detect an urgent oral health need, he said.
"One student had a serious abscess just before Thanksgiving," said Allen. "We were able to get that child antibiotics before the holiday break."
Another component of the program is education — teaching children about the benefits of brushing and flossing, for example — something Allen likes to emphasize.
"These are kids who are as deserving of proper care as any other kids, but they don't always have access to the information," he said, sometimes due to language barriers or a lack of online tools at home.
U.S. Centers for Disease Control and Prevention officials "call tooth decay the No. 1 preventable disease in children," Allen added. "A mother who has a high caries (cavity) load can pass that along to her children" unwittingly, through the sharing of food, signs of affection such as kissing and other routine activities.
The in-school teledentistry pilot, which "had more students who wanted service than we could provide it to," said Allen, is over for now, though "we might return to Aloha-Huber Park to do sealants and refer certain children into our clinic for care," he added.
VGMHC could circle back to school campuses with teledentistry services in the future, but now the nonprofit is moving on to a different population that stands to benefit: pregnant women.
"We've been doing a lot of planning and grant writing," said Bozzetti working toward a new phase of the teledentistry program based on the medical telehealth concept of virtual primary care. Care Oregon Dental, a Virginia Garcia funding partner, has pledged to help bring teledentistry to the VGMHC Women's Clinic, located on Southeast Seventh Avenue in Hillsboro.
The idea is to put dental hygienists in the same room with expectant mothers with the hope of eliminating an in-office visit they wouldn't likely make — thereby improving their overall health.
"One of the things we do really well is to take our learnings from one setting and apply them in another," said Bozzetti. "We want to have the greatest impact to the health of the most people. Helping a pregnant woman manage her own health care is a priority for us."
The projected start date for the Women's Clinic teledentistry program is April or May.
Meanwhile, Allen said, the need for better dental care for certain populations of children isn't going away.
"For younger children in general, if they have dental decay they're in pain and aren't able to focus" in the classroom, he said. "We want to provide them with services that help keep them engaged and learning."